Limitations of Health Insurance Regulation

Limitations of Health Insurance Regulation

Implementation of the Patient Protection and Affordable Care Act (PPACA) has several implications for the day-to-day operations of HSOs as well as financial implications for the physicians, staff, and specialists engaged in effective healthcare delivery. With the implementation of the PPACA, healthcare providers may be required to expand in order to provide services to newly covered patients who obtained mandated health insurance coverage. With increasing numbers of patients and consumers of health subscribed to physicians, health insurance provider networks, and HSOs, the challenge of delivering effective and quality healthcare, while also promoting patient safety, remains an issue for healthcare leaders.

As a current or future healthcare administration leader, understanding how to interpret mandates, such as the PPACA, will likely inform decision-making as it concerns day-to-day operations, cost structures, and reimbursement policies.

For this Discussion, reflect on how the implementation of the PPACA might impact operations of HSOs. Then consider how the PPACA might affect cost structures and reimbursement rates for HSOs. Think about how the PPACA might affect different types of organizations engaged in healthcare delivery.

Write an analysis of the implications of the PPACA (financial, operational, etc.) for individual institutions and explain how it impacts their cost structure and might affect reimbursement rates. Be specific and be sure to include how this might differ across different types of health services organizations.

(2- pages)

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